Clinical Manifestations and Signs of Portal Hypertension in Liver Cirrhosis

The main clinical manifestations of patients with portal hypertension due to liver cirrhosis are as follows:

Splenomegaly: a normal spleen generally weighs 140–180 g; in patients with portal hypertension the weight of the spleen may increase to 400–500 g, and in severe cases even reach 1000 g. Patients with portal hypertension have hypersplenism, which predisposes them to anemia or bleeding and other symptoms.

Gastrointestinal congestion and edema: as portal pressure rises, the return of venous blood from the stomach and intestine is obstructed, leading to congestion and edema of the gastrointestinal wall, which impairs digestion of food; patients may develop abdominal distension, poor appetite, and other symptoms.

Ascites: a pale yellow, transparent transudate, in relatively large volume.

Formation of collateral circulation: when portal hypertension obstructs portal venous return, collateral circulation forms. For example, varices of the lower esophageal venous plexus can rupture and cause fatal massive hemorrhage, a common cause of death. Varices of the rectal venous plexus can form hemorrhoids, which bleed when ruptured. Marked dilation of the superficial veins around the umbilicus can form the "caput medusae" (head of Medusa) sign.

Because time is tight with final examinations, this article is written in outline form and will be refined when I have time later.